Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Streamlining requests for RSV prophylaxis through the maze at CHEO Chuck Hui MD FRCPC Paediatric Infectious Diseases Assistant Professor of Paediatrics SUMMARY OF CHANGES FOR THE 2010-2011 RSV PROPHYLAXIS SEASON REVISED REQUEST PROCESS: • Enrolment requests will continue to be evaluated by the ministry. Initial dose requests can be processed by the ministry or by Abbott Canada (Abbott). However all subsequent monthly dose/vial requests must be faxed to Abbott for processing. REVISED MINISTRY FORMS: • Forms have been revised and enhanced with embedded tools to support and facilitate the new request process DOSE INTERVALS: • A clinical or logistical rationale must be provided if intervals between doses are too short – i.e. less than 21 days between the first and second dose and less than 30 days for all subsequent doses SEASON START: • For eastern, central, and southern Ontario, the prophylaxis season will start on or around November 1st SEASON END: • April 1st, 2011 • If requiring after April 1st, the requesting physician must confirm to the ministry that the RSV season is continuing in the patient’s area of residence by providing the date and name of the health institution that was consulted REVISED REQUEST PROCESS • All enrolment requests must be faxed to the Ministry (416-326-1990 or 877-588-1658) • INITIAL dose requests will be processed by the ministry if the 1st row of the palivizumab supply request table on page 2 of the enrolment/request form is completed and faxed at the same time as the enrolment request – Alternatively, the dose request can be submitted directly to Abbott by faxing ONLY page 2 of the enrolment form or a multi-patient order form. • All other dose requests must be faxed to Abbott (800-513-7337) for processing. Fax ONLY page 2 of the enrolment form or a multipatient order form for this purpose. Do not fax page 1 of the enrolment form to Abbott – this page contains the patients personal health information REVISED MINISTRY FORMS • • • • For the 2010-2011 RSV prophylaxis season, only the patient enrolment/request form has been significantly revised. The Risk Assessment Tool (RAT) and the multi-patient supply request forms remain the same Users can complete the forms online or download the forms in either PDF or Microsoft Word format and save it to their local system for future use. However, the forms will NOT save any information entered by a user. All recurring information (e.g. physician information) must be re-entered when the file is reopened. The links to the forms are available from the ministry’s program webpage: (http://www.health.gov.on.ca//en/public/programs/drugs/funded_drug/fund_res piratory.aspx) or from the Ontario Central Forms Repository (http://www.forms.ssb.gov.on.ca/mbs/ssb/forms/ssbforms.nsf ) • • • • Enrolment/Request Form (form: 4645-87E) Risk Assessment Tool (RAT) (form: 4646-87E) Multi-Patient Palivizumab Supply Request and Dose Report (form: 4647-87E) Multi-Patient Palivizumab Supply Request and Dose Report (Hospital Use Only) 2010-2011 2009-2010 What do you do? • Individual office/clinic, palivizumab in your clinic – Fill out enrolment form – Enroling and follow-up physician the same – Fax 2nd page to Abbott What do you do? • NICU/Clinical areas – Identify patients that qualify in a log book • Send this information to CHEO RSV clinic – If the patient is to be discharged home during the season • Fill out enrolment form • Obtain the first dose and provide in NICU • Send enrolment form to CHEO RSV clinic CHEO RSV Prophylaxis Program Website: www.cheo.on.ca -> Professionals -> Referring patients to CHEO -> RSV Prophylaxis Email: [email protected] Telephone: 613-737-7600 x2406 Fax: 613-738-4832 C1 clinic – start date November 5, 2010